General objectives :-

After completion of structured teaching programme students gain knowledge regarding fluid and electrolyte imbalance

Specific objectives:-

At the end of the teaching programme, students will be able to

1. Introduce the fluid and electrolyte imbalance

2. Define fluid and electrolyte imbalance

3. Enlist types of fluid and electrolyte

4. Enlist types of fluid and electrolyte imbalance

5. enumerate causes of fluid and electrolyte imbalance

6. Explain clinical manifestation of fluid and electrolyte imbalance

7. Explain diagnostic evaluation of fluid and electrolyte imbalance

8. Explain management of fluid and electrolyte imbalance

9. Describe complication of fluid and electrolyte imbalance

Time Specific Content Teaching Learning Av aids Evaluation

 Objective activity activity

5 min Introduce the INTRODUCTION:- Explanation Active listening Power point Are you
topic understood
The human body maintains a delicate balance of fluids and
Fluid and
electrolytes to help ensure proper functioning and
electrolyte
homeostasis. When fluids or electrolytes become
imbalance
imbalanced, individuals are at risk for organ system
dysfunction. If an imbalance goes undetected and is left ?
untreated, organ systems cannot function properly and
ultimately death will occur. Nurses must be able to
recognize subtle changes in fluid or electrolyte balances in
their patients so they can intervene promptly. Timely
assessment and intervention prevent complications and
save lives. The body is in a constant state of change as
fluids and electrolytes are shifted in and out of cells within
the body in an attempt to maintain a nearly perfect balance.
A slight change in either direction can have significant
consequences on various body systems. Body fluids consist
of water, electrolytes, blood plasma and component cells,
proteins, and other soluble particles called solutes. Body
fluids are found in two main areas of the body called
 intracellular and extracellular compartments.

An electrolyte imbalance occurs when you have too much

or not enough of certain minerals in your body. This
imbalance may be a sign of a problem like kidney disease.
Electrolytes are minerals that give off an electrical charge
when they dissolve in fluids like blood and urine. Your
body makes electrolytes. You also get these minerals from
foods, drinks and supplements. Electrolytes in blood,
tissue, urine and other body fluids play a critical role in
balancing body fluids, regulating your heart rhythm and
supporting nerve and muscle function

DEFINITION:- Define Fluid

According to the Harinderjeet:- and
2 min To define Explanation Active listening Chart
Electrolytes are minerals that control important physiologic electrolyte
Fluid and
functions of the body. An electrolyte imbalance occurs imbalance?
electrolyte
when your body’s mineral levels are too high or too low.
imbalance
This can negatively affect vital body systems.
According to American Nursing Association:-
A fluid imbalance may occur when you lose more water or
fluid than your body can take in. It can also occur when
you take in more water or fluid than your body is able to
 get rid of.
TYPES OF BODY FLIUIDS:-
Explanation Active listening Power point
To enlist the Intracellular fluids (ICF) are found inside cells and are What are the
3 min
types of Fluid made up of protein, water, electrolytes, and solutes. The types of

imbalance most abundant electrolyte in intracellular fluid is Body Fluid ?

potassium. Intracellular fluids are crucial to the body’s

functioning. In fact, intracellular fluid accounts for 60% of
the volume of body fluids and 40% of a person’s total body
weight.

Extracellular fluids (ECF) are fluids found outside of

cells. The most abundant electrolyte in extracellular fluid is
sodium. The body regulates sodium levels to control the
movement of water into and out of the extracellular space
due to osmosis.

Extracellular fluids can be further broken down into

various types. The first type is known as intravascular fluid
that is found in the vascular system that consists of arteries,
veins, and capillary networks. Intravascular fluid is whole
blood volume and also includes red blood cells, white
blood cells, plasma, and platelets. Intravascular fluid is the
 most important component of the body’s overall fluid
balance.
How many
5 min To enumerate TYPES OF ELECTROLYTES:- Active listening Chart
Explanation types of
types of
 Sodium controls fluid levels and aids nerve and electrolytes?
electrolyte
muscle function.
imbalance
 Potassium supports heart, nerve and muscle
functions. It also moves nutrients into cells and
waste products out of them while supporting your
metabolism.
 Calcium helps blood vessels contract and expand
to stabilize blood pressure. It also secretes
hormones and enzymes (proteins) that help
the nervous system send messages.
 Chloride helps maintain healthy blood
levels, blood pressure and body fluids.
 Magnesium aids nerve and muscle function. It also
promotes the growth of healthy bones and teeth.
 Phosphate supports the skeletal system, as well as
nerve and muscle function.
 Bicarbonate helps balance acids and basic alkaline
 compounds (bases) in blood (pH balance).
Bicarbonate also helps move carbon dioxide (a
waste product) through your bloodstream.

FLUID IMBALANCE:-
7 min To explain Two types of fluid imbalances are excessive fluid volume Lecture Active listening Power point What is fluid
fluid imbalance?
(also referred to as hypervolemia) and deficient fluid
imbalance volume (also referred to as hypovolemia). These
imbalances primarily refer to imbalances in the
extracellular compartment, but can cause fluid movement
in the intracellular compartments based on the sodium level
of the blood.
1)Excessive Fluid Volume
Excessive fluid volume (also referred to as hypervolemia)
occurs when there is increased fluid retained in the
intravascular compartment. Patients at risk for developing
excessive fluid volume are those with the following
conditions:
 Heart Failure
 Kidney Failure
 Cirrhosis
  Pregnancy
Symptoms of fluid overload include pitting edema, ascites,
and dyspnea and crackles from fluid in the lungs. Edema is
swelling in dependent tissues due to fluid accumulation in
the interstitial spaces. Ascites is fluid retained in the
abdomen.
Treatment depends on the cause of the fluid retention.
Sodium and fluids are typically restricted and diuretics are
often prescribed to eliminate the excess fluid.
2)Deficient Fluid Volume
Deficient fluid volume (also referred to as hypovolemia or
dehydration) occurs when loss of fluid is greater than fluid
input. Common causes of deficient fluid volume are
diarrhea, vomiting, excessive sweating, fever, and poor
oral fluid intake. Individuals who have a higher risk of
dehydration include the following:
 Older adults
 Infants and children
 Patients with chronic diseases such as diabetes
mellitus and kidney disease
 Patients taking diuretics and other medications that
cause increased urine output
  Individuals who exercise or work outdoors in hot
weather
In adults, symptoms of dehydration are as follows:
 Feeling very thirsty
 Dry mouth
 Headache
 Dry skin
 Urinating and sweating less than usual
 Dark, concentrated urine
 Feeling tired
 Changes in mental status
 Dizziness due to decreased blood pressure
 Elevated heart rate
In infants and young children, additional symptoms of
dehydration include the following:
 Crying without tears
 No wet diapers for three hours or more
 Being unusually sleepy or drowsy
 Irritability
 Eyes that look sunken
 Sunken fontanel
 ELECTROLYTE IMBALANCE:-
High electrolyte imbalances include:
To describe  Sodium: Hypernatremia.
2 min electrolyte  Potassium: Hyperkalemia Lecture cum Active listening Power point Explain
imbalance
 Calcium: Hypercalcemia discussion electrolyte

 Chloride: Hyperchloremia. imbalance?

 Magnesium: Hypermagnesemia.
 Phosphate: Hyperphosphatemia
 Bicarbonate: Alkalosis (low alkaline base).
Low electrolytes or electrolyte deficiencies include:
 Sodium: Hyponatremia
 Potassium: Hypokalemia
 Calcium: Hypocalcemia.
 Chloride: Hypochloremia.
 Magnesium: Hypomagnesemia.
 Phosphate: Hypophosphatemia
 Bicarbonate: Acidosis (high acid levels).
 CAUSES:-
To explain Certain conditions can also throw off your body’s
3 min Lecture Active listening Black board
causes of electrolyte levels. You may be more likely to develop an
electrolyte electrolyte imbalance if you have: What are the

imbalance  Burns causes of

electrolyte
 Cancer
imbalance?
 Cardiovascular disease
 High blood pressure
 Dehydration
 Vomiting
 Fever
 Diarrhea
 Over hydration
 water intoxication (drinking too much water).
 Kidney disease liver disease
 substance disorder
 Certain medications such as
 Antibiotics
 Chemotherapy
 Corticosteroids
  Diuretics and laxatives
CLINICAL MANIFESTATION:-
3 min Explanation Active listening Chart Enlist the
To enlist the
Common symptoms of electrolyte imbalances include:
symptoms of
symptoms of
 Restlessness
electrolyte
electrolyte
 Insomnia
imbalance ?
imbalance
 Tachypnea, which is rapid, shallow breathing
 Headaches
 Confusion
 Dizziness
 Nausea
 Delirium
 Fatigue
 Muscle spasms
 Vomiting
 Diarrhea
 Arrhythmia, or irregular heartbeat
 Alkalosis
Severe symptoms of electrolyte imbalances include:
 Seizures
 Coma
 Myoglobinuria
  Metabolic acidosis
DIAGNOSTIC EVALUATION:-
2 min How to
To enumerate
 A simple blood test can measure the levels of
diagnose
diagnostic
electrolytes in your body. A blood test that looks at Explanation Active listening Poster
electrolyte
evaluation of
your kidney function is important as well.
imbalance?
electrolyte
 Your doctor may want to perform a physical
imbalance
exam or order extra tests to confirm a suspected
electrolyte imbalance. These additional tests will
vary depending on the condition in question.
 For example, hypernatremia (too much sodium) can
cause skin elasticity loss due to significant
dehydration. Your doctor can perform a pinch
test to determine whether dehydration affects you.
 An electrocardiogram (ECG or EKG), an electrical
tracing of your heart, may also be useful to check
for any irregular heartbeats, rhythms, or ECG or
EKG changes brought on by electrolyte problems. How to treat
TREATMENT:- electrolyte
10 To discuss Lecture Active listening Power point
Treatment depends on the specific electrolyte imbalance imbalance?
min treatment of
and cause. Some imbalances will correct without treatment.
electrolyte
To treat dehydration, your provider may recommend
imbalance
rehydrating with electrolyte drinks or an oral rehydration
salt (ORS) solution. Your provider can tell you the correct
amount of sugar, salt and water to make this solution at
home.Certain treatments are generally used to restore the
proper balance of minerals in the body. These include:
Intravenous (IV) fluids:-
Intravenous (IV) fluids, typically containing sodium
chloride, can help rehydrate the body. This treatment is
commonly used in cases of dehydration resulting from
vomiting or diarrhea. Electrolyte supplements can be added
to IV fluids to correct deficiencies.
Certain IV medications:-
IV medications can help your body restore electrolyte
balance quickly. They can also protect you from negative
effects while being treated by another method.
The medication you receive will depend on the electrolyte
imbalance you have. Medications that may be administered
include calcium gluconate, magnesium sulfate, and
potassium chloride.
Oral medications and supplements:-
Oral medications and supplements are often used to correct
chronic mineral abnormalities in your body. This is more
common if you’ve been diagnosed with ongoing kidney
disease.
Depending on your electrolyte imbalance, you may receive
medications or supplements such as:
 calcium (gluconate, carbonate, citrate, or lactate)
 magnesium oxide
 potassium chloride
 phosphate binders, which include sevelamer
hydrochloride (Renagel), lanthanum (Fosrenol), and
calcium-based treatments such as calcium
carbonate
These can help replace depleted electrolytes on a short- or
long-term basis, depending on the underlying cause of your
disorder. To correct the imbalance, your doctor will usually
treat the underlying cause.
Hemodialysis:-
Hemodialysis is a type of dialysis that uses a machine to
remove waste from your blood.One way to get the blood to
flow to this artificial kidney is for your doctor to surgically
create a vascular access, or an entrance point, into your
blood vessels.This entrance point a larger amount of blood
to flow through your body during hemodialysis treatment.
 This means more blood can be filtered and
purified.Hemodialysis can be used to treat an electrolyte
imbalance. Your doctor may also decide on hemodialysis
treatment if the electrolyte problem has become life
threatening.
COMPLICATION:-
To discuss A significant electrolyte imbalance (either too high or too
complication low) can cause serious, life-threatening problems. These
2 min Lecture cum Active listening, Power point What are
of electrolyte complications include:
Discussion questioning complication
imbalance  Coma
of electrolyte
 Seizures.
imbalance?
 Sudden cardiac death (sudden cardiac arrest).

SUMMARY :-
An fluid and electrolyte imbalance happens when there’s too much or not enough of one or more important minerals and fluids in your body.
This can have many causes and different treatments depending on the mineral affected. It is a good idea to do your best to stay hydrated if you’re
experiencing prolonged vomiting, diarrhea, or sweating. If medications or underlying conditions cause the electrolyte imbalance, your doctor
will adjust your medication and treat the cause. This will help prevent future electrolyte imbalances. But not every electrolyte imbalance can be
easily prevented, and it could be caused by a serious condition. Visit your doctor if you’re experiencing common symptoms of an electrolyte
imbalance.

CONCLUSION :-

At the end of the class teaching respondent gain knowledge about fluid and electrolyte imbalance

RECAPTUALIZATION:-

1. Define fluid and electrolyte imbalance ?(2)

2. What are the types of fluid and electrolyte imbalance ?(2)
3. Explain management of electrolyte imbalance?(6)

BIBLIOGRAPHY:-

1. Stephen J. Mcphee, Maxine A. Papadakis, Text Book of 20011 Current Medical Diagnosis & Treatment, 50 th EditionPAGE N0.101-121
1. “D.C. DUTTA”TEXT BOOK OF OBSTETRICS PUBLISHED BY HIRALAL KONAR 7TH EDITION PAGE NO : 317-318

2. “ROSS & WILSON”ANATOMY & PHYSIOLOGY IN HEALTH & ILLNESS 10TH EDITION PAGE NO. 445-446

3. “NIMA BHASKAR” MIDWIFERY & OBSTETRICAL NURSING PUBLISHED BY MANJUNATH S. HEDGE 2 ND EDITION PAGE

NO : 237

4. ANAND ELA AND V PADUBIDRI ,TEXTBOOK OF MEDICAL SURGICAL NURSING , 1ST EDITION , PAGE NO. 84-85.

5. BALAKRISHNAN SHEILA , TEXT BOOK OF ADULT HEALTH NURSING , PARAS PUBLICATION , PARAS PUBLICATION ,

FIRST EDITION , PAGE NO. 181

6. DAFTARY N. SHIRISH , MANUAL OF OBSTETRICS , 2ND EDITION , PAGE NO. 201-202.